My EHR - Beyond the 'Meaningful Use'

February 14, 2011

A lot of practices have decided to adopt electronic health records because they “have to.” They want the stimulus money, and they know that down the road, they will be punished (financially) for not using one. And many physicians, especially the ones who have been practicing for over a decade, are doing so kicking and screaming.

A lot of practices have decided to adopt electronic health records because they “have to.” They want the stimulus money, and they know that down the road, they will be punished (financially) for not using one. And many physicians, especially the ones who have been practicing for over a decade, are doing so kicking and screaming.

It definitely takes a re-examination and a revamping of how things are done. Work flow needs to be changed in both the front and back office. Work stations need to be rearranged. It may even require that physicians change the order in which they ask questions when taking a history, and it definitely requires changing the way we document things.

So when I was planning my new office (which seems eons ago now), I had to take all of that into consideration. Laptop? Desktop? Tablet? A fixed desk or a rolling cart? How many workstations? Printers? Scanners? Where would they go? Who would need to be within arms reach of it? Could I use existing templates, or would I have to create my own?

And how would patients respond? I had heard that patients didn’t like it when docs used EHRs. They felt that the docs spent too much time looking at their screens and keyboards instead of at them. They felt it was impersonal, that docs often had their backs to the patient.

We are almost a year-and-a-half into this, and not only do patients not mind that we use computers for practically everything, they are quite impressed. When they hand us their lab results, we scan them in and hand them back the originals. We can send their results or our progress to their primary-care physician as soon as their visit is done (the docs like that, too). We can send their prescriptions directly to their pharmacy, and we know which one they usually use. We can see when we last filled their prescription and how many refills they should still have. And if an error is made (after all, humans still have to enter data), we can see who did what and when and can take responsibility and correct things.

I have had patients tell my staff or me that we are the most technologically-advanced practice they go to. I had one patient - who happens to work for some sort of IT company - praise how we use our EHR. He had been to other offices, but had some of the bad experiences I described earlier. He said that we were able to be tech savvy and still keep that patient-physician dialogue going without the hardware and software getting in the way.

My staff? There was some trepidation initially. It was a whole new experience. They were afraid it would be too hard, too cumbersome, and too labor-intensive. Now? They love it. With the click of a mouse, they know which patients’ labs have come in, if a message was left, if a prescription was sent in, if there is something on their to-do list. That medication that a patient can’t pronounce? It’s right there, and they don’t have to read my chicken-scratch.

Do I want my “meaningful use” money? Heck, yeah. But regardless, I wouldn’t go back to paper even if you paid me.